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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am suffering from eczema and I am in the

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8356 Questions

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Posted on Wed, 20 Feb 2019 in Skin Hair and Nails
Question: I am suffering from eczema and I am in the worst conditions ever with red, swollen skin, especially on face, neck, ears. Topical treatments are not working and Rx cetirizine is not either.

What kind of treatment I need to pursue to resolve or manage the condition?
doctor
Answered by Dr. Kakkar S. 14 minutes later
Brief Answer:
Acute exacerbation of eczema

Detailed Answer:
Hello and welcome to 'Ask A Doctor' service.
I have read your query and reviewed the images.

I would suggest a 7-10 day course of oral prednisolone. It would be the most appropriate for an acute exacerbation of eczema.

Apart from that, you should continue with the topical steroid, preferably a moderately potent topical steroid like either Mometasone furoate 0.1% or Triamcinolone acetonide 0.1% cream, as well as oral cetirizine tablet for sometime after the oral steroid is over.

Hope I have answered your query.
Let me know if you need any more assistance



Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Kakkar S. 47 minutes later
What causes acute exacerbation of eczema? This is the first time experiencing this condition at an acute level.

What would you recommend in preventing this condition and\or managing eczema?

Regards,
doctor
Answered by Dr. Kakkar S. 11 hours later
Brief Answer:
Regarding acute eczema

Detailed Answer:
Hi.

It could be a Photoallergic Contact Dermatitis or a Polymorphic Light Eruption (PMLE). I suggest you to avoid sun and/or use a briad spectrum sunscreen regularly and throughout the day.

take care
Let me know if you need any more assistance.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Kakkar S. 3 days later
You were very close on your recommendations. I ended up going to the emergency room. The doctor on-call give me a 60mg steroid shot at hospital. His prescribed treatment plan going forward is: a dose pack of Prednisone with 6 (10mg) pills for the first two days, 5 second to days, etc.... along with 10mg of cetirizine each day at night and diclofenac sodium topical gel, 1% which I apply 4x times a day on effective areas.

Results so far, I have no eczema outbreak below my neck; moreover, my face and ears are clearing up. My neck is still red but swelling is down and redness fading slower than on my face.

Not sure why my neck is progressing slower than the rest of my face? If you have any other recommendation, please let me know.
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
Regarding eczema

Detailed Answer:
Hi. thank you.
I would have asked you to apply a topical steroid e.g either mometasone furoate 0.1% cream or triamcinolone acetonide 0.1% cream rather than diclofenac gel. Diclofenac gel itself can cause contact dermatitis, perhaps the reason that there is redness persisting on neck despite oral steroids.

take care
Let me know if you need any more assistance
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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